Fact Sheets

Prostate Disease

The prostate is a variable sized gland located in the male pelvis, usually the size of a walnut measuring 3-4cm long and 3-5cm wide. On average the gland weighs about 20gm. The prostate surrounds the urethra which carries urine from the bladder to the penis. The seminal vesicles attach to the prostate and produce material that mixes with the prostatic fluid to form semen. The tubes from the testicles carry sperm to the prostate where the sperm are mixed with the prostate and the seminal vesicle fluid. The fluid is then ejaculated during orgasm by a connection to the urethra called the ejaculatory ducts.

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Prostate disease is a term used to describe any medical problems involving the prostate gland. Common prostate problems experienced by men include:

• Prostatitis which is inflammation and swelling of the prostate gland.
• Benign prostatic hypoplasia (BPH) which is a benign (non-cancerous) enlargement of the prostate gland.
• Prostate cancer.

Prostatitis tends to be a condition in younger men. BPH commonly occurs as men age. Prostate cancer is now the most common form of cancer in men in Australia.

BPH is one of the most common diseases affecting the prostate and is the most common benign tumour in men as they get older. This condition is present in 50% of men over 50 years. The symptoms involve noticeable changes in urination due to the effects of enlargement of the prostate around the urethra. The urinary symptoms may be obstructive (weak stream, dribbling, inadequate emptying) or irritative (urgency, frequency urination through the night). The prostate can be assessed by a digital rectal examination where a gloved and lubricated finger is inserted into the anus. The back of the prostate can thus be felt and an assessment of its size may be possible. This digital examination may also feel a cancerous lump though not all prostate cancers are palpable in this manner.

The PSA blood test (prostate specific antigen) is an important marker of prostate cancer though it is not cancer specific. It may also be raised in benign enlargement or prostatitis. Normal values for PSA blood test results are available for different age groups.

Treatments for benign enlargement of the prostate range from watchful waiting to medication to surgery. Medications derived from plants have shown some benefit, for example, Saw Palmetto. Prescription medications may reduce the prostate size thus improving symptoms, yet often this is only a temporary relief. Transurethral surgery may involve resection with a blade or the newer modalities of laser or heat treatment.

Treatment of prostate cancer is complex and the decision on the most appropriate treatment involves many factors. The choices are watchful waiting, brachytherapy, radical prostatectomy, radiotherapy and chemotherapy. More detailed descriptions of treatments for prostate disease may be found on the specialised websites which are linked to this website.